Basic Information
| Provider Information | |||||||||
| NPI: | 1093755498 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AOKI | ||||||||
| FirstName: | MAKI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, ND | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1545 DIVISADERO ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941433400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153537900 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1545 DIVISADERO ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941433400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153537900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 03/01/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 175F00000X | 1424 | OR | N | Other Service Providers | Naturopath | 390200000X | 256493 | MA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | A142122 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 278177 | 05 | OR | MEDICAID |